Wegovy, the weight-loss injection made up of the drug semaglutide, can significantly cut people鈥檚 chance of having a heart attack or stroke, a trial has found.
This might seem like just the latest in a long line of positive studies for the medicine, but doctors who work in the field say this is a key result. In time, it could become as normalised to have weight-loss injections for your health as it is to take cholesterol-lowering statins.
Semaglutide is a once-weekly injection that mimics the actions of a hormone called GLP-1, normally released after eating. It makes people feel fuller, suppresses appetite and triggers the release of the hormone insulin, which is involved in controlling blood sugar.
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The GLP-1 mimics, of which there are others, were first used for people with type 2 diabetes, but have more recently been used for weight loss, with semaglutide leading to an unprecedented 15 per cent loss in body weight. When it was launched in the US in 2021, under the brand name Wegovy, it triggered a surge of public and media interest.
There has been much moralising over whether it is right for people to use injections to control their weight. Some critics say they should instead eat more healthily and do more exercise. But certain doctors who specialise in treating obesity and diabetes have been enthusiastic about the potential of this relatively new class of medicine.
Until now, there have been two things stopping everyone who might benefit from getting access to the injections. One is their cost. In the US, Wegovy鈥檚 official manufacturer鈥檚 price is $1349 a month and while health providers typically negotiate discounts, many insurance schemes don鈥檛 cover it or require high contributions from the people taking it.
Insurers will probably widen access once they see evidence that the drug not only causes weight loss, but also prevents medical conditions 鈥� and heart disease is one of the leading causes of illness and death. The latest study showed that people taking semaglutide injections at the Wegovy dose for up to five years had a 20 per cent lower rate of heart attacks, strokes or deaths from these conditions compared with those in a placebo group. To put this into context, it is a similar degree of cardiovascular benefit as is seen when taking cholesterol-lowering statins.
鈥淭he importance of [this] trial cannot be emphasised enough,鈥� says at Weill Cornell Medicine in New York, who has been involved in other semaglutide research. 鈥淔or the first time, we have proof that using a medicine that induces weight loss in people without diabetes reduces the risk of death, heart attack and stroke in people who are otherwise being managed for hypertension and [high cholesterol].鈥�
A second access issue is that the Danish firm Novo Nordisk hasn鈥檛 been able to manufacture semaglutide fast enough to cope with the surging demand. It repeatedly delayed its launch plans for Wegovy outside of the US, although the drug has recently become available in Germany and England.
That problem may be helped by the US approval this week of a further weight loss injection, called tirzepatide (brand name Zepbound), which mimics the actions of GLP-1, as well as another hormone called GIP. While the two drugs haven鈥檛 yet been compared in a head-to-head study, a trial of tirzepatide against a placebo suggests it is even more potent than Wegovy, leading to an almost 21 per cent weight loss.
Once Zepbound is launched in the US, increased supplies of this drug class may ease shortages. What鈥檚 more, the official price for Zepbound is set to be around $1060, which may pressure Novo Nordisk to lower the cost of Wegovy. Put these events together and it suggests that in the US next year, more people will be able to get their hands on weight-loss injections who want them, and in time people in other countries will too.
Looking further ahead, when the GLP-1 mimics become available in cheaper generic versions, doctors may encourage people to control their weight with drugs with the same enthusiasm they currently have for persuading people to take statins.
The latest trial results may bring home like never before that treating obesity isn鈥檛 just a cosmetic issue, but is in fact a medical one.
NEJM
